@layout("/common/_container.html"){
<div class="ibox float-e-margins">
    <div class="ibox-content">
        <div class="form-horizontal">

            <div class="row">
                <div  class="col-sm-3" style="width:340px">
					<#NameCon id="orderNo" name="商户请求单号"  placeholder=""/>
                </div>
            </div>
            <div class="row">
                <div class="col-sm-3" style="width:340px">
                    <#NameCon id="checkRemark" name="第三方请求单号（选填）"  placeholder=""/>
                </div>
            </div>
            <div class="row">
                <div class="col-sm-3" style="width:250px">
                    结果：
                    <div id="another" name="another" class="ipt" style="width:140%;height:130px;background-color:#E0E0E0;padding:5px;10px;5px;10px;word-break:break-all;color:#428bca;"></div>
                </div>
            </div>
        </div>
                <div class="col-sm-10">
                    <#button btnCss="info" name="确定补单" id="ensure" icon="fa-check" clickFun="ThirdSupplementInfoDlg.editSubmit()"/>
                    <#button btnCss="danger" name="取消" id="cancel" icon="fa-eraser" clickFun="ThirdSupplementInfoDlg.close()"/>
                </div>
        </div>

    </div>
</div>
<script src="${ctxPath}/static/modular/huamao/thirdSupplement/thirdSupplement_info.js"></script>
@}
